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Flashcards in Pediatrics Deck (105)
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1

What does epiphyseal-metaphyseal "bucket fracture" suggest in infant?

shaking of limbs- abuse in infant

2

Diagnosis of shaken baby syndrome

optho exam: retinal hemorrhages
noncontrast CT: subdural hematoma

3

What drugs predispose to congenital heart disease (4)

alcohol
lithium
thalidomide
phenytoin

4

Maternal illness predisposing to CHD

DM, PKU

5

Infection predisposing to CHD

rubella

6

Noncyanotic heart defects (3Ds)

VSD, ASD, PDA
shunt L to R

7

Cyanotic heart defects (5 Ts)

Truncus arteriosus (One arterial vessel)
Transposition of great vessels (2 arteries switched)
Tricuspid atresia (3)
Tetralogy of Fallot (4)
Total anomolous pulmonary venous return (5 words)

8

What CHD presents with cyanosis within first few hours of life

Transposition

9

Heart defect associated with Down syndrome

ASD, endocardial defects

10

Heart defect associated with Congenital rubella

PDA

11

Heart defect associated with Turner syndrome

Coarctation of the aorta

12

Heart defect associated with neonatal lupus

congenital heart block

13

Heart defect associated with Williams syndrome

supravalvular aortic stenosis

14

Heart defect associated with DiGeorge

Tetralogy

15

Heart defect associated with maternal lithium use

Ebstein's anomoly

16

Heart defect associated with neonatal thyrotoxicosis

Heart failure

17

Heart defects associated with maternal diabetes

asymmetric septal hypertrophy
transposition

18

Neonate: Harsh holosystolic murmur at lower left sternal border

VSD

19

Neonate: wide and fixed, split S2; systolic ejection murmur LUSB

ASD

20

Exam associated with PDA

Continuous "machine-like murmur", loud S2, wide pulse pressure, bounding peripheral pulses

21

Holt-Oram syndrome (3)

absent radii, ASD, first degree heart block

22

Given to close/ open PDA

Indomethacin: Closes
PGE1: opens

23

Where is the most common location of coartation?

Just below the L subclavian artery

24

Associated with "3"s sign on CXR, rib notching

Coartcation

25

What is required to survive transposition

septal defect and PDA

26

CXR shows "egg-shaped silhouette" and increased pulm vascular markings

Transposition

27

Anomolies with tetralogy (PROVe)

Pulmonary stenosis (most imp indicator)
RVH
Overriding aorta
VSD

28

What age stranger anxiety develops

6mo

29

What age pincer grasp develops

12mo

30

Gross motor milestones:
-2mo
-4-5mo
-6mo
-12mo
-2years
-3years

-2mo: Lift head/chest
-4-5mo: Rolls front to back
-6mo: Sits unassisted
-12mo: Walks alone
-2years: Walks up/down steps
-3years: Rides tricycle

31

Language milestones:
-12mo
-15mo
-18mo
-2 year
-3 year

-12mo: 1 word, 1-step command
-15mo: 5 words
-18mo: 8 words
-2 year: 2-word phrases, 2-step command
-3 year: 3-word phrases

32

Associated with boot-shaped heart on CXR

Tetralogy

33

PE findings for tetralogy of fallot

relieved by squatting
systolic ejection murmur LUSB

34

Avg age of puberty girls, boys
Abnormal ages

Girls: 10.5 years, 8-13
Boys: 11.5 years, 9-14

35

GI, malignancy, endocrine diseases assoc with Down syndrome

Duodenal atresia
Hirschsprung's
ALL
hypothyroid

36

What does lymphedema of hands and feet indicate?

Turners

37

Associated with Large jaw, testes, ears

Fragile X syndrome

38

What does ABG for CF show?

hypochloremic alkalosis

39

Most common cause bowel obstruction first 2 years of life

intussusception

40

Associated with "currant jelly stool"

intussusception

41

Associated with "sausage-shaped" RUQ abdominal mass

intussusception

42

Associated with projectile emesis

plyoric stenosis

43

Drug causing pyloric stenosis

Erythromycin

44

Diagnosis and treatment of intussusception

air-contrast barium enema

45

Metabolic derangement associated with pyloric stenosis

hypochloremic hypokalemic metabolic alkalosis

46

Diagnosis of meckel's diverticulum

Meckel scintography scan (technitium-99m pertechnate)

47

Presents as suddem, intermittent, painless rectal bleeding in child

Meckel's diverticulum

48

Types of tissue in Meckel's diverticulum (2)

Pancreatic, gastric

49

What presents as bilious emesis in first month of life, distension, passage of blood or mucus in stool

Malrotation with volvulus

50

AXR shows "bird-beak" appearance in children

Malrotation with volvulus

51

AXR shows pneumatosis intestinalis in infant

Necrotizing enterocolits

52

When do B-cell deficiencies commonly present?

after 6mo

53

Bruton's congenital agammaglobulinemia vs transient hypogammaglobulinemia

Both show increased susceptibility to infection at 6 mo (encapsulated organisms)
B cells decreased in Bruton's not THI

54

Dangerous reactions in IgA deficiency

Anaphylactic transfusion reaction, IVIG can lead to anti-IgA antiboidies

55

Presentation of DiGeorge

Tetany (hypocalcemia) in first days of life

56

Infections in DiGeorge

viruses, fungi, PCP

57

Mnemonic for DiGeorge (CATCH 22)

Cardiac abnormalities (transposition)
Abnormal facies
Thymic aplasia
Cleft palate
Hypocalcemia
22q11 deletion

58

When do T cell deficiencies typically present

1-3 months

59

Bruton's vs CVID

Similar symptoms, CVID presents later (15-35yrs)

60

Presents with bleeding, eczema, recurrent otitis media

Wiskott-Aldrich

61

Caused by a defect in adenosine deaminase

SCID

62

Ataxia-telangiectasia defect and presentation

Defect: DNA repair
Presentation: Cerebellar ataxia, oculocutaneous telangiactasias, malignancies

63

Malignancies associated with Ataxia-telangiectasia (3)

NHL
leukemia
gastric carcinoma

64

Lab findings with Wiskott-Aldrich

Decr IgM, thrombocytopenia

65

Organisms causing infection in phagocytic deficiences

Catalase +
Fungi
Gram neg enteric organisms

66

Prophylaxis for CGD

daily TMP-SMX

67

Nitroblue tetrazolium is diagnostic

CGD

68

Presents as omphalitis with delayed separation umbilical cord

Leukocyte adhesion deficiency

69

Pneumonic for Wiskott-Aldrich (WIPE)

Wiskott-Aldrich
Infections
Purpura
Eczema

70

Presents as partial oculocutaneous albinism, peripheral neuropathy, neutropenia

Chediak-Higashi

71

Presents as Course facies, abscesses, hyper IgE, retained primary teeth, eczema

Job's

72

Job's vs WAS

Both: eczema, infections
Job's: eosinophilia, abscesses, course facies
WAS: bleeding, encapsulated organisms infection

73

Deficiency presents with recurrent Neisseria infections

Terminal complement deficiency (C5-C9)

74

Presentation of C1 esterase deficiency

recurrent episodes of angioedema

75

Kawasaki vs Scarlet fever

Both: strawberry tongue, rash, desquamation
Scarlet fever: normal lips, no conjunctivitis

76

(pediatrics) presents with recurrent high fever, hepatosplenomegaly, salmon-colored macular rash

Still's disease (RF-, ANA-)

77

Polyarthritis vs pauciarticular arthritis

Polyarthritis: >5 joints, symmetric
Pauciarticular: <4, uveitis common

78

3 common causes of otitis media

S. pneumo
non-typable h flu
Moraxella catarrhalis

79

(pediatrics) assoc with "steeple sign" on AP film

Croup

80

What antibiotic causes biliary sludging and kernicterus in newborns

Ceftriaxone

81

Classic presentation of posttussive emesis and apnea in infant <6mo

pertussis

82

Treatment of pertussis

erythromycin

83

Presents as high fever and maculopapular rash after fever breaks

Roseola infantum (HHV-6,7)

84

rash pattern for measles, rubella, roseola infantum

Measles, rubella: macular papular rash from head to toe
Roseola infantum: spreads from trunk to face and extremeties

85

Associated with posterior auricular lymphadenopathy

Rubella

86

Parvovirus B19 presentation

Slapped cheek, arthropathy, aplastic crisis

87

Of Crigler-Najjar, Dubin-Johnson, Gilbert, Rotor which is unconj, conj?

Unconj: Crigler Najjar, Gilbert
Conj: Dubin-Johnson, Rotor

88

Which type of hyperbilirubinemia is always pathologic in newborn?

Conjugated

89

CXR in newborn shows ground glass appearance

RDS

90

What malformation and malignancy associated with Beckwith-Wiedemenn?

Omphalocele
Wilms' tumor

91

Presents with bilious emesis within hours of first feeding

Duodenal atresia

92

ACXR: Double bubble sign

duodenal atresia

93

Most common acute leukemia in children

ALL

94

Presents with bone pain, fever, anemia, ecchymoses in children

Leukemia

95

Labs for tumor lysis syndrome

Hyperkalemia, hyperphosphatemia, hyeruricemia

96

Presents with nontender abdominal mass (may cross midline), horner's

Neuroblastoma

97

Histology shows round, blue tumor cells with characteristic rosette pattern

Neuroblastoma

98

WAGR syndrome

Wilms tumor
Aniridia
Gentourinary abnormalities
Mental Retardation

99

Presents with "onion skin" periosteal reaction

Ewing sarcoma

100

Location, associated symptoms for Ewings sarcoma vs osteosarcoma

Midshaft vs metaphyses
Ewing associated with systemic sx

101

Presents with "sunburst" lytic bone lesions

osteosarcoma

102

What are 3 possible dx with leukocoria in infants

Retinoblastoma
Congenital cataracts
Retinopaty of prematurity

103

Presents as irritability, intermittent abd pain, peripheral neuropathy

Lead poisoning

104

CBC shows microcytic, hypchromic anemia and basophilic stippling

Lead poisoning

105

Chelation therapies for lead poisoning

EDTA, succimer (DMSA), BAL (IM dmercaprol)